ABSTRACT
OBJECTIVE: To examine the association between dietary folate intake and antral follicle count (AFC) among women seeing treatment for infertility. DESIGN: Cohort study. SETTING: Academic fertility center. PATIENTS: A total of 552 women attending the Massachusetts General Hospital Fertility Center (2007-2019) who participated in the Environment and Reproductive Health Study. INTERVENTIONS: None. Folate intake was measured with a validated food frequency questionnaire at study entry. Multivariable Poisson regression models with robust standard errors were used to estimate the association of folate intake with AFC adjusting for calorie intake, age, body mass index, physical activity, education, smoking status, year of AFC, and intakes of vitamin B12, iron, and vitamin D. Nonlinearity was assessed with restricted cubic splines. MAIN OUTCOME MEASURE: AFC as measured by transvaginal ultrasonography as part of routine care. RESULTS: Among the 552 women (median age, 35.0 years; median folate intake, 1,005 µg/d), total and supplemental folate intake had a significant nonlinear relationship with AFC. There was a positive linear association with AFC up to approximately 1,200 µg/d for total folate intake and up to 800 µg/d for supplemental folate intake; however, there was no additional benefit of higher folate intakes. The magnitude of the association was modest; for example, the predicted adjusted difference in AFC between a woman consuming 400 vs. 800 µg/d of supplemental folate was approximately 1.5 follicles. CONCLUSION: Higher intake of folate, particularly from supplements, was associated with modestly higher ovarian reserve as measured by AFC among women attending a fertility center. CLINICAL TRIAL REGISTRATION NUMBER: This trial was registered at clinicaltrials.gov as NCT00011713.
Subject(s)
Folic Acid/administration & dosage , Infertility, Female , Ovarian Reserve/physiology , Adult , Cell Count , Cohort Studies , Dietary Supplements , Female , Fertility Clinics , Humans , Infertility, Female/diet therapy , Infertility, Female/epidemiology , Infertility, Female/pathology , Massachusetts/epidemiology , Ovarian Follicle/pathology , Ovarian Reserve/drug effectsABSTRACT
OBJECTIVE: Anogenital distance (AGD), the distance from the centre of the anus to the genitals, is a sexually dimorphic phenotype in mammals. Several experimental studies have demonstrated that AGD is a biomarker of prenatal androgen exposure during the masculinisation period of development. The objective of this study was to assess the relationship between AGD (as an indirect marker of prenatal hormonal environment) and severity of the surgical specimen and prostate cancer (PCa) prognosis. METHODS: We conducted a cross-sectional study with a total of 119 PCa patients with confirmed biopsy of the tumour. Every participant underwent a physical examination where two variants of the AGD were assessed, a) from the anus to the cephalad insertion of the penis (AGDAP) and b) to the posterior base of the scrotum (AGDAS). To assess the association between both AGD and severity and PCa prognosis multiple logistic regression analysis was used. RESULTS: Longer AGDAS was significantly associated with biochemical recurrence and affected margins of the surgical specimen (OR: 2.5; IC 95%:1.2-5.5, and 2.8; IC 95%: 1.1-7.5, respectively). CONCLUSIONS: Our findings suggest that a higher prenatal androgen exposure, resulting in a longer AGD, is associated with worse prognosis of PCa.
Subject(s)
Anal Canal/anatomy & histology , Genitalia, Male/anatomy & histology , Prostatic Neoplasms , Aged , Body Size , Cross-Sectional Studies , Humans , Male , Middle Aged , Prognosis , Prostatic Neoplasms/surgery , Severity of Illness IndexABSTRACT
OBJETIVO: La distancia anogenital (DAG) es un marcador de desarrollo genital que presenta un dimorfismo sexual en mamíferos. Diversos estudios experimentales han demostrado que la DAG al nacimiento refleja la exposición androgénica a la que el feto ha estado expuesto durante su desarrollo intrauterino. El objetivo de nuestro estudio fue analizar la asociación entre la DAG (como marcador indirecto del ambiente hormonal intrauterino) y la severidad en la pieza quirúrgica y el pronóstico del cáncer de próstata (CaP). MÉTODOS: Se trata de un estudio transversal que incluyó 119 pacientes intervenidos de CaP y con confirmación histológica por biopsia. A cada paciente se le realizó una exploración física y se midieron dos variantes de DAG; a) medida desde la inserción posterior del pene en el abdomen bajo al borde superior del ano (DAGAP) y b) medida desde la base posterior del escroto al borde superior del ano (DAGAS). La asociación entre ambas DAG y los indicadores de severidad y pronóstico postquirúrgicos de CaP se realizaron mediante análisis de regresión logística múltiple. RESULTADOS: La DAGAS se asoció significativamente con la recidiva bioquímica y márgenes afectados en la pieza quirúrgica (OR: 2,5; IC 95%: 1,2-5,5, y 2,8; IC 95%: 1,1-7,5, respectivamente). CONCLUSIÓN: Nuestros resultados sugieren que una mayor exposición androgénica prenatal, reflejado en una DAG alargada, estaría asociada con un peor pronóstico del CaP
OBJECTIVE: Anogenital distance (AGD), the distance from the centre of the anus to the genitals, is a sexually dimorphic phenotype in mammals. Several experimental studies have demonstrated that AGD is a biomarker of prenatal androgen exposure during the masculinisation period of development. The objective of this study was to assess the relationship between AGD (as an indirect marker of prenatal hormonal environment) and severity of the surgical specimen and prostate cancer (PCa) prognosis. METHODS: We conducted a cross-sectional study with a total of 119 PCa patients with confirmed biopsy of the tumour. Every participant underwent a physical examination where two variants of the AGD were assessed, a) from the anus to the cephalad insertion of the penis (AGDAP) and b) to the posterior base of the scrotum (AGDAS). To assess the association between both AGD and severity and PCa prognosis multiple logistic regression analysis was used. RESULTS: Longer AGDAS was significantly associated with biochemical recurrence and affected margins of the surgical specimen (OR: 2.5; IC 95%:1.2-5.5, and 2.8; IC 95%: 1.1-7.5, respectively). CONCLUSIONS: Our findings suggest that a higher prenatal androgen exposure, resulting in a longer AGD, is associated with worse prognosis of PCa
Subject(s)
Humans , Male , Middle Aged , Aged , Anal Canal/anatomy & histology , Genitalia, Male/anatomy & histology , Prostatic Neoplasms/surgery , Body Size , Cross-Sectional Studies , Prognosis , Severity of Illness IndexABSTRACT
El cociente entre la longitud del segundo y cuarto dedo (2D:4D) de la mano es un rasgo de dimorfismo sexual, presentando los hombres una ratio menor que las mujeres.1 Varios estudios de cohortes2,3 y un metaanálisis,4 han mostrado que la diferencia de género en la ratio de los dedos se asocia con la exposición de andrógenos prenatales. El cociente 2D:4D está inversamente relacionado a la exposición intrauterina de testosterona (T) y directamente relacionado a la de estradiol.2 Existe evidencia que afirma que la ratio 2D:4D podría ser un marcador válido para los niveles hormonales del adulto (T y estrógeno),3 aunque ese dato es controvertido.4Por esa razón, el cociente 2D:4D seha utilizado como un biomarcador no invasivo y retrospectivo para la exposición prenatal de andrógenos, y se ha correlacionado con una amplia gama de enfermedades como el autismo,5 así como la cognición visoespacial y la orientación sexual.6
The quotient between the length of the second and fourth finger (2D:4D) hand is a trait of sexual dimorphism, featuring the men a lower ratio than women.1 Several studies of the cohorts2,3 and a meta-analysis,4 have shown that the difference between The gender ratio of the fingers is associated with the exposure of prenatal androgens. The quotient 2D:4D is inversely related to intrauterine testosterone (T) exposure and directly related to that of estradiol.2 There is evidence which states that the 2D:4D ratio could be a valid marker for adult hormone levels (T and estrogen),3 although that data is controversial.4 For that reason, the 2D:4D quotient has been used as a noninvasive and retrospective biomarker for prenatal exposure to androgens, and it has been correlated with a wide range of diseases such as autism,5 as well as such as visuospatial cognition and sexual orientation.6
